It could retrieve work from a server to start long running processes that mine cryptocurrency. And scan every IP/port on your local network and use metasploit to send matching exploits to everything it sees. And then hijack a local process running under a different user with disk write permissions.
I would like to see macros restricted similar to Javascript in the browser. You can still run code and manipulate local data, but you don't get any direct access to the host OS. No disk access, no registry access, no way to create a process, only able to calculate things and change the document itself. And there must be no checkbox to disable these protections.